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Article Dans Une Revue Archives of cardiovascular diseases Année : 2023

Cardiogenic shock in adults with congenital heart disease: Insights from the FRENSHOCK registry

Eric Bonnefoy
  • Fonction : Auteur
Laurent Bonello
  • Fonction : Auteur
Bruno Levy
  • Fonction : Auteur
Sébastien Champion
  • Fonction : Auteur
Francis Schneider
  • Fonction : Auteur
Alain Cariou
  • Fonction : Auteur
Hadi Khachab
  • Fonction : Auteur
Jeremy Bourenne
  • Fonction : Auteur
Marie-France Seronde
  • Fonction : Auteur
Gérald Vanzetto
  • Fonction : Auteur
Charlotte Quentin
  • Fonction : Auteur
Xavier Delabranche
  • Fonction : Auteur
Nicolas Combaret
Olivier Morel
  • Fonction : Auteur
Benoit Lattuca
  • Fonction : Auteur
Laurent Leborgne
  • Fonction : Auteur
Emmanuelle Fillippi
Clara Brusq
  • Fonction : Auteur
Vanina Bongard
  • Fonction : Auteur
Etienne Puymirat
Clément Delmas

Résumé

Background: Data on cardiogenic shock in adults with congenital heart disease (ACHD) are scarce.Aim:We sought to describe cardiogenic shock in ACHD patients in a nationwide cardiogenic shock registry.Methods: From the multicentric FRENSHOCK registry (772 patients with cardiogenic shock from 49 French centres between April and October 2016), ACHD patients were compared with adults without congenital heart disease (non-ACHD). The primary outcome was defined by all-cause mortality, chronic ventricular assist device or heart transplantation at 1 year.Results: Out of the 772 patients, seven (0.9%) were ACHD, who were younger (median age: 56 vs. 67 years), had fewer cardiovascular risk factors, such as hypertension (14.3% vs. 47.5%) and diabetes (14.3% vs. 28.3%), and no previous ischaemic cardiopathy (0 vs. 61.5%). Right heart catheterization (57.1% vs. 15.4%), pacemakers (28.6% vs. 4.6%) and implantable cardioverter-defibrillators (28.6% vs. 4.8%) were indicated more frequently in the management of ACHD patients compared with non-ACHD patients, whereas temporary mechanical circulatory support (0 vs. 18.7%) and invasive mechanical ventilation (14.3% vs. 38.1%) were less likely to be used in ACHD patients. At 1 year, the primary outcome occurred in 85.7% (95% confidence interval: 42.1–99.6) ACHD patients and 52.3% (95% confidence interval: 48.7–55.9) non-ACHD patients. Although 1-year mortality was not significantly different between ACHD patients (42.9%) and non-ACHD patients (45.4%), ventricular assist devices and heart transplantation tended to be more frequent in the ACHD group.Conclusions: Cardiogenic shock in ACHD patients is rare, accounting for only 0.9% of an unselected cardiogenic shock population. Despite being younger and having fewer co-morbidities, the prognosis of ACHD patients with cardiogenic shock remains severe, and is similar to that of other patients.
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Dates et versions

hal-04183605 , version 2 (21-08-2023)
hal-04183605 , version 1 (09-11-2023)

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Clément Karsenty, Anthony Touafchia, Magalie Ladouceur, François Roubille, Eric Bonnefoy, et al.. Cardiogenic shock in adults with congenital heart disease: Insights from the FRENSHOCK registry. Archives of cardiovascular diseases, In press, ⟨10.1016/j.acvd.2023.06.008⟩. ⟨hal-04183605v2⟩
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